Autism Spectrum Disorder

Children on the autism spectrum typically achieve milestones like sitting, crawling, and walking on time. However, subtle differences in gestures (such as pointing), pretend play, and social language often go unnoticed by families and doctors.

One key indicator is a delay in or lack of joint attention, which is the ability to share focus on an object or event with another person. This skill is crucial for developing later social and communication abilities.

For instance, by 12 months of age, most children can follow a parent’s pointing gesture and then look back at the parent with a smile. In contrast, a child on the autism spectrum might appear to ignore the gesture, leading to concerns about their hearing.

By 15 months, most children can point to objects they want. However, a child on the autism spectrum may instead lead a parent to the object without much eye contact, sometimes even placing the parent’s hand on the object.

By 18 months, most children point to share interest in something, looking back and forth between the object and the parent to ensure shared attention. Children with autism, however, may point to request an object from a parent rather than to share enjoyment.

Regarding language, almost all children with autism experience delays in both nonverbal and verbal communication. They may use words to label objects but struggle to use words to request things. They might also repeat words or phrases they hear (parroting) for an extended period.

Some children with autism initially seem to meet language milestones but use language in unusual ways, such as sounding more like an adult than a toddler.

Additionally, about 25% of children with autism experience a regression in language and social skills between 15 and 24 months. They may stop using language they previously had and become more socially withdrawn, a phenomenon known as skill regression.